S3049
Invited Speaker
ESTRO 2026
interdisciplinary framework is essential to support safe implementation and foster confidence across the team. RTT feedback highlights an initial learning curve, followed by clear benefits in daily practice, including reduced intra-fraction variability, improved reproducibility, and greater control over treatment delivery. Workflow adaptation remains efficient, with treatment durations compatible with routine clinical schedules despite the added technical component. From a patient perspective, RTTs report good overall tolerance, with reduced effort compared to voluntary breath-hold techniques and a reassuring perception of guided breathing. Effective communication and patient preparation remain key to successful implementation. MANIV-DIBH exemplifies how multidisciplinary collaboration and targeted training can transform RTT practice, supporting the delivery of precise, reproducible, and standardised radiotherapy in motion-sensitive indications, and enabling further integration with advanced approaches such as online adaptive radiotherapy. 5535 Psycho-oncological interventions in radiotherapy exemplify interdisciplinary collaboration, improving patient and caregiver well-being Gabriella Pravettoni Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy Radiotherapy represents a central modality in cancer treatment, often characterized by highly technical procedures, repeated sessions, and specific environmental stressors. While generally well tolerated, toxicity can significantly impact patients’ physical and psychological well-being. The need to navigate complex information, cope with daily treatment routines, and manage uncertainty about outcomes highlights the importance of targeted psycho-oncological guidance and support. Guiding and supporting patients and caregivers is therefore a central task, aimed at fostering adaptation, resilience, and quality of life. Patients undergoing radiotherapy frequently report anxiety related to the treatment process, including fear of radiation, concerns about side effects, and distress associated with immobilization devices and treatment settings. Additionally, the cumulative nature of treatment, often delivered over several weeks, may lead to emotional fatigue and decreased coping resources over time. Psycho-oncological interventions aim to provide patients with clear, comprehensible information, facilitate emotional expression, and
improvements in clinical processes, reducing actual or potential hazards and contributing to safer radiotherapy services across Australia and New Zealand.
5533 Immobilisation and mobile tumours treatment: A challenging paradox ...? Christel Abdel Massih, Geneviève Van Ooteghem Radiotherapy, Cliniques universitaires Saint Luc, Brussels, Belgium Respiratory motion remains a major source of geometric uncertainty in radiotherapy for thoracic and upper abdominal tumours, particularly in lung, liver, and pancreatic indications. Conventional motion management strategies—including internal target volume approaches, respiratory gating, tumour tracking, and voluntary deep inspiration breath-hold (DIBH)—are limited by variability in patient performance, complex workflows, and inconsistent reproducibility. These constraints place RTTs at the forefront of motion management, requiring continuous adaptation, technical expertise, and patient interaction. Mechanically Assisted Non-Invasive Ventilation combined with deep inspiration breath-hold (MANIV- DIBH) enables passive, stable, and reproducible breath-holds of approximately 20–30 seconds through controlled delivery of two pressure levels. This approach fundamentally changes RTT practice by reducing dependence on active patient coaching and enabling a more standardised and predictable workflow. In current clinical practice, MANIV-DIBH is implemented for lung, liver, and pancreatic tumours, where motion control is critical for precise target definition and safe dose delivery. From an image guidance perspective, the technique significantly improves IGRT quality, with reduced motion artefacts, enhanced target visibility, and increased inter- and intra-fraction reproducibility compared with free-breathing acquisitions. For RTTs, this translates into more confident image interpretation, streamlined decision-making, and improved consistency in patient positioning and verification. The integration of MANIV-DIBH requires a structured multidisciplinary approach. RTTs develop specific competencies in ventilator handling, patient installation, respiratory cycle monitoring, and coordination of breath-hold sequences with treatment delivery. Training is delivered through close collaboration with radiation oncologists, physiotherapists, and nursing staff, ensuring a shared understanding of technical principles, safety procedures, and clinical objectives. This
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